NR565 Advanced Pharmacology
Fundamentals Latest Update
Statin Pharmacokinetics - ANSWER-metabolized by CYP3A4; most of an absorbed dose is extracted from
the blood on its first pass through the liver; rapid hepatic metabolism followed by excretion primarily in
the bile; partial excretion in urine.
Statins Monitoring - ANSWER-Cholesterol levels should be monitored monthly early in treatment and at
longer intervals thereafter.
Strategies to Address Opioid Crisis - ANSWER-1) Improving access to treatment and recovery services
2)Promoting use of overdose-reversing drugs
3)Strengthening our understanding of the epidemic through better public health surveillance
4)Providing support for cutting-edge research on pain and addiction
5)Advancing better practices for pain management
Subcategory of Pure Opioid Agonist - ANSWER-strong opioid agonists; moderate to strong opioid
agonists
Substance Use Disorder (SUD) - ANSWER-According to the American Psychiatric Association, a cluster of
cognitive, behavioral, and physiological symptoms indicating that the individual continues using the
substance despite significant substance-related problems
Summary of Key Prescribing Considerations β-Adrenergic Antagonists - ANSWERPrincipal indications are
hypertension, angina pectoris, heart failure, and cardiac dysrhythmias; Monitoring for heart rate, blood
pressure, other adverse effects
Therapeutic Action for Angina - ANSWER-Nitrates, Beta-Blockers, Ranalozine, CCB
Thiazide "Hyper" Toxicity" - ANSWER-hyper-GLUC
HyperGlycemia
,NR565 Advanced Pharmacology
Fundamentals Latest Update
HyperLipidemia
HyperUricemia
HyperCalcemia
Thiazide Adverse Effects - ANSWER-Hyponatremia
Hypochloremia
Hypomagnesemia
Hypotension
Hypokalemia
Hyperglycemia
Hyperuricemia (may precipitate gout)
Hyperlipidiemia
Reduction of HDL cholesterol
Increase in LDL cholesterol and triglycerides
Thiazide Diuretic Mechanism of Action - ANSWER-promotes urine production by blocking the
reabsorption of sodium and chloride in the early segment of the distal convoluted tubule
Thiazide Diuretic Prototype Drug - ANSWER-Hydrochlorothiazide
Thiazide Diuretics Treatment Goal/Therapeutic Use - ANSWER-Hypertension; Edema; referred agent for
treating stage 1 hypertension;
Preferred initial HTN therapy for treating African Americans
Reduce BLOOD VOLUME; VENOUS PRESSURE; PRELOAD
,NR565 Advanced Pharmacology
Fundamentals Latest Update
Thiazide Diuretics; Prescribing Concerns - ANSWER-patients with cardiovascular disease, renal
impairment, diabetes mellitus, history of gout; patients taking digoxin, lithium, or antihypertensive
drugs. Should be avoided in those allergic to sulfa
Thiazide Drug Interactions - ANSWER-Digoxin
Sulfa Drugs
Ototoxic drugs
Potassium-sparing diuretics
Lithium
Antihypertensive agents
NSAIDs
Thiazide Monitoring - ANSWER-Monitor blood pressure and pulse rate; also, patients should weigh
themselves daily and evaluate for decreased edema. Have patients monitor for signs or symptoms of
HYPOKALEMIA
Three possible outcomes of phase 1 drug metabolism. - ANSWER--Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active
Thrombolytic Drugs - ANSWER-promote the lysis of fibrin, causing the dissolution of thrombi. (Alteplase-
TPA)
Treatment for acute gout - ANSWER-NSAIDS; Colchicine
Treatment for recurrent/chronic gout - ANSWER-Allopurinol; Febuxostat
, NR565 Advanced Pharmacology
Fundamentals Latest Update
Types of Acute Pain - ANSWER-Referred Pain
Acute Somatic Pain
Acute visceral pain
Verapamil Adverse Effects - ANSWER-Constipation; dizziness, facial flushing, headache, and edema of
the ankles and feet
Verapamil and Diltiazem High Risk Patients - ANSWER-CONTRINDICATED in patients with hypotension,
sick sinus syndrome, and second- or third-degree atrioventricular block.
Verapamil and Diltiazem Monitoring - ANSWER-No routine blood monitoring required.
Verapamil and Diltiazem Therapeutic Indication - ANSWER-hypertension, angina, and cardiac
dysrhythmias.
Verapamil Effects - ANSWER-Blockade at peripheral arterioles causes dilation and thereby reduces
arterial pressure.
120 mg per day of morphine milligram equivalents - ANSWER-Referral to a pain specialist is required for
patients who take this dose of Morphine Milligram Equivalents
Absorption Interaction - ANSWER-result of a change due to one medication's effect on another
medication's route of entry into the body.
ACE Inhibitor Drug Interactions - ANSWER-Diuretics may intensify first-dose hypotension; other
antihypertensive agents;
HYPERKALEMIA RISK: AVOID Drugs That Raise Potassium Levels;
Lithium;
Fundamentals Latest Update
Statin Pharmacokinetics - ANSWER-metabolized by CYP3A4; most of an absorbed dose is extracted from
the blood on its first pass through the liver; rapid hepatic metabolism followed by excretion primarily in
the bile; partial excretion in urine.
Statins Monitoring - ANSWER-Cholesterol levels should be monitored monthly early in treatment and at
longer intervals thereafter.
Strategies to Address Opioid Crisis - ANSWER-1) Improving access to treatment and recovery services
2)Promoting use of overdose-reversing drugs
3)Strengthening our understanding of the epidemic through better public health surveillance
4)Providing support for cutting-edge research on pain and addiction
5)Advancing better practices for pain management
Subcategory of Pure Opioid Agonist - ANSWER-strong opioid agonists; moderate to strong opioid
agonists
Substance Use Disorder (SUD) - ANSWER-According to the American Psychiatric Association, a cluster of
cognitive, behavioral, and physiological symptoms indicating that the individual continues using the
substance despite significant substance-related problems
Summary of Key Prescribing Considerations β-Adrenergic Antagonists - ANSWERPrincipal indications are
hypertension, angina pectoris, heart failure, and cardiac dysrhythmias; Monitoring for heart rate, blood
pressure, other adverse effects
Therapeutic Action for Angina - ANSWER-Nitrates, Beta-Blockers, Ranalozine, CCB
Thiazide "Hyper" Toxicity" - ANSWER-hyper-GLUC
HyperGlycemia
,NR565 Advanced Pharmacology
Fundamentals Latest Update
HyperLipidemia
HyperUricemia
HyperCalcemia
Thiazide Adverse Effects - ANSWER-Hyponatremia
Hypochloremia
Hypomagnesemia
Hypotension
Hypokalemia
Hyperglycemia
Hyperuricemia (may precipitate gout)
Hyperlipidiemia
Reduction of HDL cholesterol
Increase in LDL cholesterol and triglycerides
Thiazide Diuretic Mechanism of Action - ANSWER-promotes urine production by blocking the
reabsorption of sodium and chloride in the early segment of the distal convoluted tubule
Thiazide Diuretic Prototype Drug - ANSWER-Hydrochlorothiazide
Thiazide Diuretics Treatment Goal/Therapeutic Use - ANSWER-Hypertension; Edema; referred agent for
treating stage 1 hypertension;
Preferred initial HTN therapy for treating African Americans
Reduce BLOOD VOLUME; VENOUS PRESSURE; PRELOAD
,NR565 Advanced Pharmacology
Fundamentals Latest Update
Thiazide Diuretics; Prescribing Concerns - ANSWER-patients with cardiovascular disease, renal
impairment, diabetes mellitus, history of gout; patients taking digoxin, lithium, or antihypertensive
drugs. Should be avoided in those allergic to sulfa
Thiazide Drug Interactions - ANSWER-Digoxin
Sulfa Drugs
Ototoxic drugs
Potassium-sparing diuretics
Lithium
Antihypertensive agents
NSAIDs
Thiazide Monitoring - ANSWER-Monitor blood pressure and pulse rate; also, patients should weigh
themselves daily and evaluate for decreased edema. Have patients monitor for signs or symptoms of
HYPOKALEMIA
Three possible outcomes of phase 1 drug metabolism. - ANSWER--Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active
Thrombolytic Drugs - ANSWER-promote the lysis of fibrin, causing the dissolution of thrombi. (Alteplase-
TPA)
Treatment for acute gout - ANSWER-NSAIDS; Colchicine
Treatment for recurrent/chronic gout - ANSWER-Allopurinol; Febuxostat
, NR565 Advanced Pharmacology
Fundamentals Latest Update
Types of Acute Pain - ANSWER-Referred Pain
Acute Somatic Pain
Acute visceral pain
Verapamil Adverse Effects - ANSWER-Constipation; dizziness, facial flushing, headache, and edema of
the ankles and feet
Verapamil and Diltiazem High Risk Patients - ANSWER-CONTRINDICATED in patients with hypotension,
sick sinus syndrome, and second- or third-degree atrioventricular block.
Verapamil and Diltiazem Monitoring - ANSWER-No routine blood monitoring required.
Verapamil and Diltiazem Therapeutic Indication - ANSWER-hypertension, angina, and cardiac
dysrhythmias.
Verapamil Effects - ANSWER-Blockade at peripheral arterioles causes dilation and thereby reduces
arterial pressure.
120 mg per day of morphine milligram equivalents - ANSWER-Referral to a pain specialist is required for
patients who take this dose of Morphine Milligram Equivalents
Absorption Interaction - ANSWER-result of a change due to one medication's effect on another
medication's route of entry into the body.
ACE Inhibitor Drug Interactions - ANSWER-Diuretics may intensify first-dose hypotension; other
antihypertensive agents;
HYPERKALEMIA RISK: AVOID Drugs That Raise Potassium Levels;
Lithium;
